CT scan results

I read your other posts to get some background.

Who ordered the CT scan? Was it primary care doc or GI? Was it with oral contrast (drinking a lot of a liquid before getting in the machine)? Was it with any IV contrast (given through IV during the procedure)?

Have you had any stool testing done? Have you had blood tests done? Did they include CRP or ESR in your blood tests?

If you haven't already, the next things you should do would be the CRP blood test and a stool test for what is called fecal calprotectin.

You should also get a referral to a GI and set up an appointment for a colonoscopy. And, given your other posts about reflux/upper GI symptoms, you should probably get an upper endoscopy too (they can do them at the same time - I've had a few at the same time). They sedate you for the scopes, so that part is super easy. The hard part is drinking the prep the night before and spending half the night on the toilet.

This doesn't look like UC to me, but there's a chance it could be Crohn's.disease. There's also a chance it's neither one, or nothing at all. But since the CT scan shows something a little abnormal, further testing is warranted.

Did your blood tests include CRP (C reactive protein)?

Did your stool tests include fecal calprotectin?

Those should be done.

Frankly, the CT scan would have been much better if they had included oral contrast. But it's possible that the facility where you had your scan doesn't have that capability. The oral contrast helps get better images of the small bowel and the bowel walls. The results from your CT scan are not at all conclusive, but they show that there *could* be some inflammation in the wall of a segment of your colon. A colonoscopy will allow a better view and will allow the doc to take biopsies, which are key to figuring out what if anything is really going on.

There's nothing to be terrified of with the scopes. You'll be totally out in a matter of seconds, and then you'll wake up 20 or 30 minutes later with no memory of it. I've had about six or seven colonoscopies and six or seven upper endoscopies. I've done some with what they call "twilight sedation" and I've had some done with propofol (a stronger sedation). Both put me out in seconds and both ways worked fine.

I think there’s a good chance there’s nothing wrong with you. That radiologist could not have written a more vague, nonspecific interpretation of a film.

The prep for the colonoscopy is no fun. Drinking that stuff is a hassle causing lots of pooping and can interfere with a normal night’s sleep.

That said, the drugs you’re scheduled for are Heavenly. That’s the bright side.

Good luck

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On Humira

Thanks for the reply!

What have you done to decrease your pain?

Ok, appreciate the input. I guess I’ll keep plugging away at these tests. I do feel mine is digestion related since I can take pepto or Pepcid and they normally relieve the pain temporarily. I’ll see what the docs thoughts are this week I suppose.

Beave,

Obviously I worry about the worst outcome, would IV contrast allow them to see tumors or at least rule out the worst (stomach/bowel cancer)?

I happen to a radiologist, and therefore quite familiar enough with CT scans. For what its worth, IV contrast can get a great look at the bowel mucosa, and iodinated oral contrast is actually not needed. In fact many centers are giving patients a liter of water to drink before the scan because this has been found to provide enough distention of the small and large bowel to see what is going on with the mucosa and surrounding tissues (that being said, if one is looking for a bowel leak after surgery or something like that, then that is another story).

Regarding the results you mentioned (without seeing the images myself) there is nothing in there that would concern me too much if it were my scan. So I have to agree with island time about that not being the most helpful report and straydog regarding endoscopy/ colonoscopy.

I would not say lazy. Sometimes there is things we see and we can’t be quite sure so we give differential diagnosis (multiple things it could be) or a suggestion and expect the ordering doctor to use the clinical context to decide if it means anything.

Regarding bowel cancer, the short answer is no. Sometimes they get big enough to see or big enough to cause an obstruction (or other compilation). But just because a CT says normal does not mean a small cancer in the stomach, small bowel, large bowel is hiding.

No, this is not bad at all, the dr is doing his job. Depending on where you live it can take many weeks to get scopes scheduled.

Be thankful you have a good dr in your corner. In the meantime, try to lower your stress level.

Yep, agree with straydog - that's a good thing that your doctor is so responsive. Good luck with the procedures and definitely let us know how it goes.

Guys, idk if I can go through with endoscopy. I just don’t think I’ll make it through the procedure.

I told the doctor I needed to be put out to even consider doing the procedure. He said ok he would do MAC sedation. However, when the nurse called me to schedule, she tried to schedule “twilight” sedation and said it would be fine. I insisted on MAC so it sounds like that’s what I’m scheduled for. But it still sounds like I am awake for the procedure and will still need to “swallow” the camera? I just don’t think I’ll be able to do it. I was a nervous wreck before a CT scan, where you literally lay on a table. It’s the easiest thing in the world and I have done it before so I even knew what to expect and was still sitting there sweating.